DEPARTMENT OF INSURANCE

Name	Atlantic Ins Brokerage	DOIID	966791	NAIC NPN	16341714

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Life	9/11/2017	3/31/2019
Inactive	Non Resident	Agent	Health	9/11/2017	3/31/2019

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	8797 Willow Cove Lane Lake Worth, FL 33467

Phone Information

Type	Phone
Business / Home Office	(877) 561-2422